Keith Alan Lopatka, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036-113547 Issued in IL

Practice address

7300 W College Dr
Ste 1NW
Palos Heights, IL 60463-1152

Phone

(708) 671-1374

Fax

(708) 671-1378

NPI assigned

Jul 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Micrographic Dermatologic Surgery (MDS)Also: Dermatology

Education

Loyola University of Chicago, Stritch School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Illinois Dermatology Institute, LLCGroup PAC ID 7911043054, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Illinois Dermatology Institute, LLC

  • Dermatology Physician
  • Skokie, IL
  • NPI 1891920898
  Medicare reassignment Care Compare group Authorized official
• Illinois Dermatology Institute, LLC

  • Medical Specialty Clinic/Center
  • Park Ridge, IL
  • NPI 1447613989
  NPD
• Eugene Mandrea, M.D., S.C.

  • Dermatology Physician
  • Palos Heights, IL
  • NPI 1184615387
  NPD (past)
• Physicians Dermpath Laboratory

  • Dermatopathology Physician
  • Park Ridge, IL
  • NPI 1376866897
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1770509648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR",
            "address_2": "STE 1NW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631152",
            "telephone_number": "708-671-1374",
            "fax_number": "708-671-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 W COLLEGE DR",
            "address_2": "STE 1NW",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631152",
            "telephone_number": "708-671-1374",
            "fax_number": "708-671-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPATKA",
        "first_name": "KEITH",
        "middle_name": "ALAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-113547",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "01056082A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-113547",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael J. Littleton, OT
• Lloyd J Blakeman III Dosc
• Alessa Locke
• Jessica Joan Loftus, PH.D.
• Lauren Lonergan
• Lotus Life Counseling
• Michael Lou, MD
• Demetric Love, RT(R)
• Jennifer Lubinski, LCSW
• Lucas Chiropractic Center S C

• Dermatology Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.